Blood test for 'bad cholesterol' could more accurately predict heart disease risk, study finds
28 April 2025, 09:22
A test assessing specific particles in the blood could better predict a person’s risk of developing heart disease compared to measuring cholesterol, according to a new study.
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It has long been understood that having high cholesterol levels in the blood can increase the risk of heart disease and stroke.
In Britain, doctors typically check a patient’s blood pressure and family history if they suspect they are at risk of heart disease.
They will also normally take a blood sample to measure the amount of different types of fat in the blood, including cholesterol.
But now, researchers from Sweden and the US have argued that there may be a more accurate way to find out if you are at risk.
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They say that detecting the level of proteins associated with “bad cholesterol” could “potentially save lives”
These particles transport cholesterol and other fats in the bloodstream and can deposit cholesterol in the walls of blood vessels if many are present.
Another type helps remove excess cholesterol from the blood and transports it back to the liver, and is sometimes referred to as “good cholesterol”.
Jakub Morze, postdoctoral fellow at Chalmers University of Technology in Gothenburg, said: “This is the largest study of its kind to date and the results show for the first time the relative importance of the three major families of lipoprotein for the potential risk of heart disease.
“It was previously unclear if two patients with the same total level of ‘bad cholesterol’, but that differ in their carrier characteristics – lipoprotein type, size, lipid content – have the same risk of heart disease.”
Researchers analysed blood samples from 207,368 people in the UK Biobank with no history of heart disease for the study.
"We found that apoB is the best marker when testing for risk of heart disease," Morze added.
“Since apoB indicates the total number of ‘bad cholesterol’ particles, measuring it offers a more accurate test than standard cholesterol measures.
“That does not mean conventional tests are ineffective; they generally perform well. However, in about one in 12 patients, standard cholesterol tests may underestimate heart disease risk, which is important to consider, since 20 – 40% of all first-time occurrences of CVD are fatal.
“By switching to apoB testing, we can improve that accuracy and potentially save lives.”
In an analysis of 2022, the British Heart Foundation (BHF) found that 80 in every 100,000 in England died from heart and circulatory diseases before the age of 75.
This was the highest level since 2011, which saw 83 per 100,000 die prematurely.
The rate of early deaths from heart disease has risen year-on-year since 2020, showing a clear reversal in the previous trend of falling death rates from cardiovascular diseases.
Despite the fall in death rates between 2012 and 2019, the BFH said there had been a “significant slowdown” in the rate of improvement since 2012.
Between 2012 and 2019, the premature death rate for cardiovascular disease in the UK fell by just 11%, compared to a fall of 33% between 2005 and 2012.Since 2020, the death rate has almost risen by 13%.
